eprintid: 10190215 rev_number: 9 eprint_status: archive userid: 699 dir: disk0/10/19/02/15 datestamp: 2024-04-09 13:47:39 lastmod: 2024-04-09 13:47:39 status_changed: 2024-04-09 13:47:39 type: article metadata_visibility: show sword_depositor: 699 creators_name: Cozzi-Lepri, Alessandro creators_name: Borghi, Vanni creators_name: Rotundo, Salvatore creators_name: Mariani, Bianca creators_name: Ferrari, Anna creators_name: Del Borgo, Cosmo creators_name: Bai, Francesca creators_name: Colletti, Pietro creators_name: Miraglia, Piermauro creators_name: Torti, Carlo creators_name: Cattelan, Anna Maria creators_name: Cenderello, Giovanni creators_name: Berruti, Marco creators_name: Tascini, Carlo creators_name: Parruti, Giustino creators_name: Coladonato, Simona creators_name: Gori, Andrea creators_name: Marchetti, Giulia creators_name: Lichtner, Miriam creators_name: Coppola, Luigi creators_name: Sorace, Chiara creators_name: D'Abramo, Alessandra creators_name: Mazzotta, Valentina creators_name: Guaraldi, Giovanni creators_name: Franceschini, Erica creators_name: Meschiari, Marianna creators_name: Sarmati, Loredana creators_name: Antinori, Andrea creators_name: Nicastri, Emanuele creators_name: Mussini, Cristina title: Development and validation of a prediction score for failure to casirivimab/imdevimab in hospitalized patients with COVID-19 pneumonia ispublished: pub divisions: UCL divisions: B02 divisions: D01 divisions: G16 keywords: casirivimab/imdevimab, COVID-19, mechanical ventilation, mortality, prediction score, SARS-CoV-2 note: © 2024 the Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). abstract: INTRODUCTION: Casirivimab and imdevimab (CAS/IMV) are two non-competing, high-affinity human IgG1 anti-SARS-CoV-2 monoclonal antibodies, that showed a survival benefit in seronegative hospitalized patients with COVID-19. This study aimed to estimate the day-28 risk of mechanical ventilation (MV) and death in individuals hospitalized for severe COVID-19 pneumonia and receiving CAS/IMV. Additionally, it aimed to identify variables measured at the time of hospital admission that could predict these outcomes and derive a prediction algorithm. METHODS: This is a retrospective, observational cohort study conducted in 12 hospitals in Italy. Adult patients who were consecutively hospitalized from November 2021 to February 2022 receiving CAS/IMV were included. A multivariable logistic regression model was used to identify predictors of MV or death by day 28 from treatment initiation, and β-coefficients from the model were used to develop a risk score that was derived by means of leave-one-out internal cross-validation (CV), external CV, and calibration. Secondary outcome was mortality. RESULTS: A total of 480 hospitalized patients in the training set and 157 patients in the test set were included. By day 28, 36 participants (8%) underwent MV and 28 died (6%) for a total of 58 participants (12%) experiencing the composite primary endpoint. In multivariable analysis, four factors [age, PaO2/FiO2 ratio, lactate dehydrogenase (LDH), and platelets] were independently associated with the risk of MV/death and were used to generate the proposed risk score. The accuracy of the score in the area under the curve (AUC) was 0.80 and 0.77 in internal validation and test for the composite endpoint and 0.87 and 0.86 for death, respectively. The model also appeared to be well calibrated with the raw data. CONCLUSION: The mortality risk reported in our study was lower than that previously reported. Although CAS/IMV is no longer used, our score might help in identifying which patients are not likely to benefit from monoclonal antibodies and may require alternative interventions. date: 2024 date_type: published publisher: FRONTIERS MEDIA SA official_url: http://dx.doi.org/10.3389/fmed.2024.1293431 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2263748 doi: 10.3389/fmed.2024.1293431 medium: Electronic-eCollection lyricists_name: Cozzi-Lepri, Alessandro lyricists_id: ACOZZ70 actors_name: Cozzi-Lepri, Alessandro actors_id: ACOZZ70 actors_role: owner full_text_status: public publication: Frontiers in Medicine volume: 11 article_number: 1293431 pages: 9 event_location: Switzerland citation: Cozzi-Lepri, Alessandro; Borghi, Vanni; Rotundo, Salvatore; Mariani, Bianca; Ferrari, Anna; Del Borgo, Cosmo; Bai, Francesca; ... Mussini, Cristina; + view all <#> Cozzi-Lepri, Alessandro; Borghi, Vanni; Rotundo, Salvatore; Mariani, Bianca; Ferrari, Anna; Del Borgo, Cosmo; Bai, Francesca; Colletti, Pietro; Miraglia, Piermauro; Torti, Carlo; Cattelan, Anna Maria; Cenderello, Giovanni; Berruti, Marco; Tascini, Carlo; Parruti, Giustino; Coladonato, Simona; Gori, Andrea; Marchetti, Giulia; Lichtner, Miriam; Coppola, Luigi; Sorace, Chiara; D'Abramo, Alessandra; Mazzotta, Valentina; Guaraldi, Giovanni; Franceschini, Erica; Meschiari, Marianna; Sarmati, Loredana; Antinori, Andrea; Nicastri, Emanuele; Mussini, Cristina; - view fewer <#> (2024) Development and validation of a prediction score for failure to casirivimab/imdevimab in hospitalized patients with COVID-19 pneumonia. Frontiers in Medicine , 11 , Article 1293431. 10.3389/fmed.2024.1293431 <https://doi.org/10.3389/fmed.2024.1293431>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10190215/2/Cozzi-Lepri_Development%20and%20validation%20of%20a%20prediction%20score%20for%20failure%20to%20casirivimab_imdevimab%20in%20hospitalized%20patients%20with%20COVID-19%20pneumonia_VoR.pdf